Psych nursing is easy

psychrn2008 · Jan 16, 2016

I did med/surg and critical before psych and I often think of returning. To me medical was easier because even though it could be physically taxing it was often very black and white. Psych every situation is different. When that borderline breaks out the light fixture and cuts herself for the 100th time and there's so much scar tissue they cant even suture it, when you have the psychotic patient tearing apart the unit and you are technically voluntary :bored: so no seclusion room but only 4 points, having to pull patients off of staff members etc. Its considered one of the most dangerous professions. There are many nights Ive gone home way more worn out than when I worked medical. I don't know where you work but you sound lucky

nickfitz1969 · Jan 16, 2016

I did med/surg and critical before psych and I often think of returning. To me medical was easier because even though it could be physically taxing it was often very black and white. Psych every situation is different. When that borderline breaks out the light fixture and cuts herself for the 100th time and there's so much scar tissue they cant even suture it, when you have the psychotic patient tearing apart the unit and you are technically voluntary so no seclusion room but only 4 points, having to pull patients off of staff members etc. Its considered one of the most dangerous professions. There are many nights Ive gone home way more worn out than when I worked medical. I don't know where you work but you sound lucky

It sounds as though the mental health environments where you have worked where patients are breaking light fixtures or psychotic patients are tearing apart the unit, is not only unsafe but staffed by inexperienced staff. I have worked in a variety of acute mental health facilities in 3 countries and never experienced anything like you describe. I would imagine that it is due to the nursing education provided in the US, where RN's are general trained and not specialist trained as they are in the UK. I've never worked in environments where we used archaic manual restraints and treated people like animals! It indicates to me the quality of the mental health system in some places in the US.

psychrn2008 · Jan 16, 2016

It sounds as though the mental health environments where you have worked where patients are breaking light fixtures or psychotic patients are tearing apart the unit, is not only unsafe but staffed by inexperienced staff. I have worked in a variety of acute mental health facilities in 3 countries and never experienced anything like you describe. I would imagine that it is due to the nursing education provided in the US, where RN's are general trained and not specialist trained as they are in the UK. I've never worked in environments where we used archaic manual restraints and treated people like animals! It indicates to me the quality of the mental health system in some places in the US.

Mental health in the US is awful. We are so underfunded we cant keep staff to save our lives and I actually work in one of the "safer" places as in I don't work at the state hospital. The state hospital where I live a staff member was raped by a pt recently and another was put into a coma for a week.

My unit just recently started taking higher acuity patients many staff are not used to that level of psychosis or borderline. Its difficult also because we are mostly voluntary so we have no seclusion room, and for some reason doctors around here are really timid with meds so people end up in restrain to protect themselves. doesn't happen all the time. I would say about once a month some is in restraint. Most of the time we just have a bunch of 1:1s. I feel like people are getting sicker and sicker. US is rough in the mental health field. Especially when your attached to a hospital so they still try to do the whole pt satisfaction thing. It really doesn't work well in psych

nickfitz1969 · Jan 16, 2016

Mental health in the US is awful. We are so underfunded we cant keep staff to save our lives and I actually work in one of the "safer" places as in I don't work at the state hospital. The state hospital where I live a staff member was raped by a pt recently and another was put into a coma for a week.
My unit just recently started taking higher acuity patients many staff are not used to that level of psychosis or borderline. Its difficult also because we are mostly voluntary so we have no seclusion room, and for some reason doctors around here are really timid with meds so people end up in restrain to protect themselves. doesn't happen all the time. I would say about once a month some is in restraint. Most of the time we just have a bunch of 1:1s. I feel like people are getting sicker and sicker. US is rough in the mental health field. Especially when your attached to a hospital so they still try to do the whole pt satisfaction thing. It really doesn't work well in psych

Psychrn2008, Why do nurses continue to work in such conditions. The conditions will never change if nurses don't do something about it! Why are nurses putting themselves, and vicariously their families at risk of harm? Doing nothing allows the continuation of such problems. I don't understand why professional people don't seem to understand that, although they normally have an excuse to do nothing! Why do nurses value themselves so little that they put themselves in harms way?

psychrn2008 · Jan 16, 2016

Psychrn2008, Why do nurses continue to work in such conditions. The conditions will never change if nurses don't do something about it! Why are nurses putting themselves, and vicariously their families at risk of harm? Doing nothing allows the continuation of such problems. I don't understand why professional people don't seem to understand that, although they normally have an excuse to do nothing! Why do nurses value themselves so little that they put themselves in harms way?

Nurses are afraid, we are treated as replaceable. We have literally been told "don't like it go somewhere else" A lot of places are afraid to unionize or speak up. Healthcare in general in the US s a mess right now. Too focused on patient satisfaction scores and reimbursements instead of safety. Hopefully it will change but nurses need to unite. A few of us speaking up does nothing but get us fired and black listed. So people just stay quiet. I will say the state hospital is fighting back after that girl was raped. It was really tragic, no one had been doing rounds they were understaffed. She responded to a pt crying for help and he drug her in the room and raped her and injured her trachea, another pt saved her. It shook the mental health community here. But until staffing and funding improves it wont get much better.

Can't-make-this-up · Feb 24, 2016

Do you know where the fire extinguisher is location the unit? Tell me how easy being a psychiatric nurse is after you have to watch a patient melt in front of your eyes after said patient doused themselves with lighter fluid and came to desk and set their body ablaze. Go home after that shift and say "wow this psych nursing is really easy." Walk into a room with your patient hanging from the water pipes and as you hold the patients body up screaming for you colleagues to get the scissors to cut them down and no one can find them! Do you know where your emergency scissors are located on your unit? Your just sitting at the desk doing your charts and a patient launches themselves over the barrier and bites your colleagues nose and won't let go. How do you respond to this situation when you know it will take at least 1-10 minutes for security to arrive? Will you place yourself in harms way to protect or minimize the damage being done to your colleagues face? Oh and while this is happening there is an audience of other patients who will judge your every move, word and body language. Yes, there are days when working on a psychiatric unit can be calm and dare I say fun. But you must always be aware and always be thinking one step ahead of the really sick patients who will engage in the most bizarre behaviour so fast your mind doesn't have time to process what is going on. That my young new nurse is when the instinct of the experienced nurses on the unit will save your life and license. Now go home and enjoy the fact that your feet do not hurt..but be aware if your head is not hurting from all the observation and managing the milieu of the unit then you are not doing your job in an effective manner.

VersatileRN · May 17, 2016

The majority of RNs on this site agree their patient workloads are manageable. To me.... That equals EASY. Considering the ER/trauma center workload is never manageable.

elkpark · May 17, 2016

The majority of RNs on this site agree their patient workloads are manageable. To me.... That equals EASY. Considering the ER/trauma center workload is never manageable.

Nah, we're just really good at what we do. But you'll find out soon enough, I guess.

chevyv, BSN, RN · May 18, 2016

The majority of RNs on this site agree their patient workloads are manageable. To me.... That equals EASY. Considering the ER/trauma center workload is never manageable.

Ah ha. If that is your definition of easy, take some time and cone work with us. Even with 7 pts, q 15 min checks, the volatile behaviors where it takes the police minutes to get there....I guess that's super easy. One call in and I now have 8-10 pts with extra volatile pts.

geek, BSN · May 21, 2016

The majority of RNs on this site agree their patient workloads are manageable. To me.... That equals EASY. Considering the ER/trauma center workload is never manageable.

You seem to have joined for the express purpose of trolling psych nurses

JVLims · May 27, 2016

Perhaps your lack of proficiency leads you to that perception-I am a case management nurse in a acute care general hospital and am assigned to multiple units, one of which is an acute adult psychiatric unit. Working with patients in the milieu requires more than talking with them-you need to be perceiving the needs of the patients based on diagnosis, guarding against splitting, maintaining appropriate boundaries, implementing the multidisciplinary treatment plan, assessing for response to psychopharmacologic regimens. At all times, you need to have a focus on maintaining safety-theirs and yours. To feel at ease to the extent you do would put you in harm's way on many acute units. I am curious as to your characterization of your patients are "plain adult psych" as many, many patients with mental illness are dually diagnosed-I would say conservatively 75-80 percent of ours have a coexisting SUD....very unusual in my experience to have such a population.

JVLims · May 27, 2016

Please don't generalize. Statutes governing care vary from state to state. Our locked unit almost never uses physical or chemical restraint. The entire unit is retrofitted to prevent the use of things like fixtures for self harm or harm to others. In our Commonwealth, we cannot give meds over objection without first obtaining a court order in court sessions held our unit unless there is imminent danger-a high bar. Generalized training may not prepare nurses in the way that your specialized training does, but it gives our nurses a good foundation from which to start. Having said that, our patients are often more similar to a forensic population and occasionally, dangerous situations occur when you are dealing with an unpredictable and acutely destabilized population.